Table of Contents
Prologue by Msgr. Charles Fahey, SJ
Introduction: The Essential Spirit by Donald Koepke, M.Div, BCC
How do we define spirituality? We will further explore this in subsequent chapters, but we begin with a definition of spirituality as a person’s core beliefs that influenced are influenced by all of the domains of life, only one of which is religion. Everyone might not have a religion, as culture defines a religion, but everyone has a spirituality.
Principles behind Older Adult Spirituality
Chapter 1. Spirituality, the Sacred Domain: Core Concepts and Implications for Practice for Older Adults
How does the spiritual works within individual persons? The chapter offers caregivers and other professionals an insight into the inner workings of clients and residents of long-term care. In addition, the chapter explores therapeutic goals for spiritual care from the perspective of religious leaders, social workers, nurses, and hands-on long term care staff such as Certified Nursing Assistants (CNAs), and shares spiritual assessment strategies that include questions revealing personal spirituality that are acceptable to theists and non-theists alike.
Chapter 2. Finding Meaning in Perceived Meaninglessness
Rev. James W. Ellor, Ph.D, D. Min, LCSW, ACSW, BCD, DCSW, CSW-G
One of the most pressing spiritual needs and challenges experienced by both family and professional caregivers of the elderly is that of finding meaning in old age. Existential Psychotherapy suggests that there is no inherent meaning in a world that is impersonal and devoid of meaning except for those meanings that are attributed by the individual. A discussion about how Viktor Frankl understands this essential need for meaning as well as ways this concept can help service providers effectively engage the spiritual challenges found in the latter years.
Chapter 3. Spirituality and the Brain: We See in Part
Paul Dobies, OD
Recent brain research and understanding provides physiological evidence for the use of spirituality to enhance the provision of service with older adults by any discipline. The need for and core of the spiritual is because “we do not know that we do not know.”
Chapter 4. Religion: Friend or Foe
Peggy Price, D.Min
Often religious issues are ignored for fear of accusation of proselyting or exploring irrelevant material. This chapter advocates for the inclusion of the client’s religious thought and practice as a means of enhancing the service provision by persons of all disciplines. If a client is theistic and the service provider does not include the client’s use of personal religious perspectives, an essential part of the person is lost. Clinically helpful insights from all of the great world religions are included.
Practical Strategies for Engaging Spirituality in Older Adults
Fostering Spirituality in Dementia: Looking Beyond Cognition
Cordula Dick-Muehlke, Ph.D
In this hyper-cognitive culture, the experience of dementia asks a deeply spiritual question: “What does it mean to be human?” Does a person have to be able to cognate in order to be accepted as being human? If a person’s spirituality is their core values and beliefs, how does a family member or caregiver engage the spirituality of persons with mild cognitive impairment, moderate dementia, advanced dementia when their ability to engage in meaningful conversations becomes more and more limited.
Chapter 6. The Essential Spirit in Caresharing
Marty Richards, LICSW
Caregiving has often been envisioned as a one-way experience with the caregiver doing the giving (active, dominant) and the care receiver doing the receiving (passive role). This chapter explores a new paradigm of “Caresharing” where both the ‘giver’ and the ‘receiver’ are partners in the task of providing care.
Chapter 7. Care-Giving: Body, Mind and Spirit
Giovanna Piazza, M.Div, BCC
This chapter creatively explores the task of caregiving by examining archetypical patterns of belief among caregivers and corresponding patterns of behavior which could be problematic in healthy self-care. A few of the archetypes examined are: the Ghost, the Martyr and the Perfectionist. Specific spiritual practices are suggested for each archetype.
Chapter 8. Touching Spirits: Programming for Meaning and Connection
Nancy Gordon, MSLS, M.Div.
The activity professional is a key person in the lives of residents in a long term care community. In fact they can be an essential spiritual leader in the way that activities are developed, scheduled and implementation. The author asks the essential activity question: “What is being accomplished through our activity program? Entertainment that fills the hours until one dies or events that touch the heart, is filled with meaning, and encourages growth of core beliefs?”
Chapter 9. Using Rituals to Engage the Spirit
Rabbi Richard Address, D.Min, Ph.D (honorary from HUC-JIR 1999)
Many rituals, both religious and secular, have been practiced throughout the life of the client and thus may assist the client find insight to their lives as well as cope with the many challenges of old age. To give a client, even one with very limited cognition, a cross to hold, a yarmulke to wear or a rug on which to pray, allows that client to again connect with their core of being, an experience is not cognitive but experiential.
Chapter 10. Transforming Suffering into Spiritual Energy: The Practice of ‘Dedicated Suffering’
Jane Thibault, Ph.D
The many physical, psychological and social challenges of aging often evoke in older adults a perception of suffering. The driving force of this chapter is to address suffering, cope with suffering, even gain meaning in suffering through a process called dedicated suffering.
Chapter 11. Money in Older Age
Donald Koepke, M.Div, BCC
Finances, or the lack thereof, whether real or imagined, weigh heavily on the hearts of older adults. “Will I have enough to see me through these ‘golden years’ that is filled with opportunity but also struggle and tragedy?” ”What is going to happen if I run out of money?” This chapter explores the spirituality of money and its place in aging by encouraging clients to search their core beliefs regarding money and its role in their lives, providing insights and even the words for service providers of all disciplines to effectively address issues surrounding money with their clients.
Chapter 12. Death and Dying, the Final Act of Living
G. Jay Westbrook, MSG
Providing service to the dying has long been a recognized province of spiritual care. Dying exposes the effect of core beliefs and values though out the client’s life. Most hospice providers are highly skilled with engaging a client’s spirituality. This chapter expands those skills so that persons of all disciplines, both within and outside hospice, can hear and appropriately respond to this most personal of all experiences of life: dying.
Epilogue. Looking in a Mirror
Nancy Gordon, MLS, M.Div and Donald Koepke M.Div, BCC
Spirituality is such a personal component to the life of a client that it is essential that the service provider becomes aware of his or her own spiritual journey and beliefs. The goal is that this awareness might assist providers to avoid coloring the clients experience and beliefs with their own. Strategies for exploring the provider’s personal theistic or non-theistic view of spirituality provide the clinician with a personal foundation for effectively engaging the spirituality of the client.